Modified frailty index predicts medical complications, length of stay, readmission, and mortality following total shoulder arthroplasty

Background Chronic obstructive pulmonary disease patients have been shown in orthopedic literature to have poorer outcomes and higher rates of complications from surgery. In this retrospective review, medical complications, length of stay, and costs were obtained to explore the effects of chronic obstructive pulmonary disease on patients undergoing primary total shoulder arthroplasty. Methods Total shoulder arthroplasty cases from January 2005 to March 2014 were queried and analyzed from a nationwide database. Study patients were matched 1:5 to controls by age, sex, and medical comorbidities associated with chronic obstructive pulmonary disease. In-hospital length of stay, 90-day medical complications, day of surgery, and total global 90-day episode of care costs were obtained for comparison. Results Chronic obstructive pulmonary disease patients were found to have higher incidence and odds (53.91 vs. 11.95%; OR: 3.58, 95%CI: 3.18–3.92, p < 0.0001) of 90-day medical complications, longer in-hospital length of stay (3 vs. 2 days, p < 0.0001), and significantly higher 90-day costs ($14,768.37 vs. $13,379.20, p < 0.0001) following primary total shoulder arthroplasty compared to matched controls. Discussion Chronic obstructive pulmonary disease patients undergoing primary total shoulder arthroplasty have higher rates of medical complications, in-hospital length of stay, and costs of care. This represents an important factor that will allow orthopedic surgeons to adequately manage expectations and educate chronic obstructive pulmonary disease patients of the potential complications which may occur following total shoulder arthroplasty.

Download Full-text

Medical Complications and Outcomes After Total Shoulder Arthroplasty: A Nationwide Analysis

The American Journal of Orthopedics ◽

10.12788/ajo.2018.0086 ◽

2018 ◽

Vol 47 (10) ◽

Cited By ~ 1

Author(s):

Oke A. Anakwenze ◽

Evan A. O’Donnell ◽

Charles M. Jobin ◽

William N. Levine ◽

Christopher S. Ahmad

Keyword(s):

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Medical Complications

Download Full-text

Modified-Frailty Index Does Not Independently Predict Complications, Hospital Length of Stay or 30-Day Readmission Rates Following Posterior Lumbar Decompression and Fusion for Spondylolisthesis

The Spine Journal ◽

10.1016/j.spinee.2021.05.011 ◽

2021 ◽

Author(s):

Aladine A. Elsamadicy ◽

Isaac G. Freedman ◽

Andrew B. Koo ◽

Wyatt B David ◽

Benjamin C. Reeves ◽

...

Keyword(s):

Length Of Stay ◽

Frailty Index ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Readmission Rates ◽

Lumbar Decompression ◽

Modified Frailty Index

Download Full-text

Malnutrition: a marker for increased complications, mortality, and length of stay after total shoulder arthroplasty

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2015.07.034 ◽

2016 ◽

Vol 25 (2) ◽

pp. 193-200 ◽

Cited By ~ 30

Author(s):

Grant H. Garcia ◽

Michael C. Fu ◽

David M. Dines ◽

Edward V. Craig ◽

Lawrence V. Gulotta

Keyword(s):

Length Of Stay ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty

Download Full-text

Predictors of length of stay after elective total shoulder arthroplasty in the United States

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2014.11.042 ◽

2015 ◽

Vol 24 (5) ◽

pp. 754-759 ◽

Cited By ~ 44

Author(s):

John C. Dunn ◽

Joseph Lanzi ◽

Nicholas Kusnezov ◽

Julia Bader ◽

Brian R. Waterman ◽

...

Keyword(s):

United States ◽

Length Of Stay ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

The United States

Download Full-text

Impact of tranexamic acid on clinical and hematologic outcomes following total shoulder arthroplasty

Shoulder & Elbow ◽

10.1177/17585732211023053 ◽

2021 ◽

pp. 175857322110230

Author(s):

McKayla Kelly ◽

Justin Turcotte ◽

M Brook Fowler ◽

Michaline West ◽

Cyrus Lashgari ◽

...

Keyword(s):

Length Of Stay ◽

Tranexamic Acid ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Univariate Analysis ◽

Reverse Total Shoulder Arthroplasty ◽

Complication Rates ◽

Vein Thrombosis ◽

Reverse Total Shoulder ◽

The Impact

Background The purpose of this study is to evaluate the impact of intravenous tranexamic acid on clinical and hematologic outcomes after total shoulder arthroplasty. Methods Retrospective review was conducted for 282 consecutive patients undergoing either anatomic shoulder arthroplasty or reverse total shoulder arthroplasty. Univariate analysis and multivariate linear regression were used to compare outcomes for patients receiving intravenous tranexamic acid with those who did not. Results Of the 282 patients included in this study, 78 patients received intravenous tranexamic acid and 204 did not. Patients who received intravenous tranexamic acid had significantly lower pre- to postoperative change in hemoglobin and hematocrit, and decreased postoperative drain output. In addition, patients receiving intravenous tranexamic acid were significantly less likely to have a postoperative hematocrit <30. There were no significant differences in length of stay, rate of 30 day hematoma, surgical site infection, deep vein thrombosis, or readmission between groups. Conclusion Intravenous tranexamic acid is associated with a significant reduction in change in hematocrit and hemoglobin and postoperative drain output after both anatomic and reverse total shoulder arthroplasty. Despite improving hematologic outcomes for these patients, tranexamic acid appears to have little impact on clinical outcomes such as length of stay and 30-day complication rates.

Download Full-text

The impact of solid organ transplant history on inpatient complications, mortality, length of stay, and cost for primary total shoulder arthroplasty admissions in the United States

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2018.02.064 ◽

2018 ◽

Vol 27 (8) ◽

pp. 1429-1436

Author(s):

Tennison L. Malcolm ◽

Kiran Chatha ◽

Adam P. Breceda ◽

Eric Guo ◽

Darren J. Friedman ◽

...

Keyword(s):

United States ◽

Length Of Stay ◽

Shoulder Arthroplasty ◽

Total Shoulder Arthroplasty ◽

Organ Transplant ◽

The United States ◽

Solid Organ Transplant ◽

Solid Organ ◽

The Impact

Download Full-text

Thirty-day morbidity and mortality following revision total shoulder arthroplasty in octogenarians

Shoulder & Elbow ◽

10.1177/17585732211027334 ◽

2021 ◽

pp. 175857322110273

Author(s):

Puneet Gupta ◽

Theodore Quan ◽

Zachary R Zimmer

Keyword(s):

Pulmonary Embolism ◽

Postoperative Complications ◽

Length Of Stay ◽

Shoulder Arthroplasty ◽

Multivariate Analyses ◽

Total Shoulder Arthroplasty ◽

Morbidity And Mortality ◽

Old Patients ◽

Increased Risk ◽

Extended Length

Background Octogenarians are at an increased risk of morbidity and mortality following various surgeries, but this has not yet been well explored in octogenarians undergoing revision total shoulder arthroplasty (RTSA). Thus, the purpose of this study was to analyze whether octogenarians undergoing RTSA are at an increased risk of 30-day postoperative complications, readmissions, and mortality relative to the younger geriatric population. Methods Data of patients who underwent RTSA from 2013 to 2018 were obtained from a large de-identified database. Patients were divided into two cohorts: ages 65–79 and ages 80–89. Demographic data, comorbidities, and postoperative complications were collected and compared between the two cohorts. Bivariate and multivariate analyses were performed. Results On bivariate analyses, patients aged 80–89 were more likely to develop pulmonary embolism (p = 0.014) and extended length of stay more than 3 days (p = 0.006) compared to the cohort aged 65–79. Following adjustment on multivariate analyses, 80–89 years old patients no longer had an increased likelihood of pulmonary embolism or extended length of stay compared to the 65–79 age group. Octogenarians were not found to have higher rates of 30-day readmissions (p = 0.782), mortality (p = 0.507), reoperation (p = 0.785), pneumonia (p = 0.417), urinary tract infection (p = 0.739), or sepsis (p = 0.464) compared to the cohort aged 65–79 following RTSA. Conclusion Age greater than 80 should not be used independently as a factor for evaluating whether a geriatric patient is a proper candidate for RTSA.

Download Full-text

Incidence and Risk Factors of In-hospital Prosthesis-Related Complications Following Total Shoulder Arthroplasty

10.21203/rs.3.rs-1142426/v1 ◽

2021 ◽

Author(s):

Qinfeng Yang ◽

Hao Xie ◽

Shencai Liu ◽

Xuanping Wu ◽

Zhanjun Shi ◽

...

Keyword(s):

Risk Factors ◽

Native American ◽

Length Of Stay ◽

Shoulder Arthroplasty ◽

Nationwide Inpatient Sample ◽

Shoulder Arthroscopy ◽

Metastatic Cancer ◽

Total Shoulder Arthroplasty ◽

American Hospital ◽

Nationwide Inpatient Sample Database

Abstract BackgroundThe occurrence of prosthesis-related complications after total shoulder arthroplasty is devastating and costly. The purpose was to determine the incidence and risk of in-hospital prosthesis-related complications after total shoulder arthroplasty utilizing a large-scale sample database.MethodsA retrospective database analysis was performed based on Nationwide Inpatient Sample from 2010 to 2014. Patients who underwent total shoulder arthroplasty were included. Patient demographics, hospital characteristics, length of stay, economic indicators, in-hospital mortality, comorbidities, and peri-operative complications were evaluated.ResultsA total of 34,198 cases were capture from the Nationwide Inpatient Sample database. There were 343 cases of in-hospital prosthesis-related complications after total shoulder arthroplasty and the overall incidence was 1%, with a more than 2.5-fold decrease from 2010 to 2014. Dislocation was the most common category among prosthesis-related complications (0.1%). The occurrence of in-hospital prosthesis-related complications was associated with significantly more total charges and slightly longer length of stay while less usage of Medicare. Risk factors of prosthesis-related complications were identified including younger age (<64 years), female, the native American, hospital in the South, alcohol abuse, depression, uncomplicated diabetes, diabetes with chronic complications, fluid and electrolyte disorders, metastatic cancer, neurological disorders, and renal failure. Interestingly, advanced age (≥65 years) and proprietary hospital were found as protective factors. Furthermore, prosthesis-related complications were associated with aseptic necrosis, rheumatoid arthritis, rotator cuff tear arthropathy, Parkinson’s disease, prior shoulder arthroscopy, and blood transfusion.ConclusionsIt is of benefit to study risk factors of prosthesis-related complications following total shoulder arthroplasty to ensure the appropriate management and optimize consequences although a relatively low incidence was identified.

Download Full-text